System and Method for Mobile Platform Designed for Digital Health Management and Support for Remote Patient Monitoring

ABSTRACT

A mobile application is used for monitoring and management of users or patients with various health or disease conditions. Software system provides a platform with which the medical histories, the recent conditions and real-time measurement data for the patient can be organized and shared among various people who are involved in the caring of the patient. In addition to data sharing in a secured, private networking environment, the platform integrates the essential functions for people in the various caregivers’ groups to communicate with each other in real-time so as to collaborate on the caring of the patient.

CROSS REFERENCE TO RELATED APPLICATIONS

The present application claims priority from Provisional PatentApplication No. 62/248,251 filed on Oct. 29, 2015 and Provisional PatentApplication No. 62/311,922 filed on Mar. 23, 2016, which areincorporated herein by reference in its entirety.

BACKGROUND

The mobile phone users may have a basic feature phone for simple voicecalls and text messaging. Smartphone technology could be costly andquite complex for some users, e.g. elderly with little education orpatients with serious conditions. The software system is designed toavoid those constraints through the connections between the patients andtheir caregivers. It would support collaborations in the care of apatient by multiple people in the same group or across different groups,including but not limited to: Family members, Relatives, Neighbors,Friends, Personal nurses, Household helpers, Nursing homes, andProfessional care teams (i.e. providers, nurses, doctors andspecialists).

For patients who may not have access or capability to use the mHealthApplication (App) on the smartphone themselves, their caregivers, e.g.some of those in one or more of the groups as listed above, who are“connected” to them, would be able to use the App to “monitor” and“manage” their “diseases” and “health status”, “taking appropriateactions depending on the conditions”.

For patients who are able to use the mHealth App on their smartphones,they would be able to use it to communicate with others who areconnected with them via the App, e.g. to chat (voice, video or text)about their conditions, get advice and attention from their caregiversetc.

The platform supports the creation of personal health (medical) records,with configurable options for sharing and maintenance by selectedindividuals who are connected to the patient / user. The patient’shealth record on the phone can be updated manually or automaticallythrough physiological or biosensors worn by the patients, and/orenvironmental sensors. The updates could be visible to the closest(first-level) caregivers who are connected to the patient via the App.

SUMMARY OF THE INVENTION

Based on the proliferation of mobile devices, a family/group-centricmobile health platform could be used as a tool for the mobile users tomonitor and manage the health conditions of their family members. Usingthis platform, family members can store and organize the health data foreach family member, which enables them to track their health conditions,manage the care of a baby, elderly or sick family membercollaboratively, and share the care-giving responsibilities, evenremotely. The platform allows the closest caregivers to be connected tothe patient with visibility to the latest health conditions throughupdates on vital signs, manually or automatically via interface withvital sign sensors, in addition to the historical health conditions.Multiple alert levels can be configured remotely for different thresholdconditions and caregiver groups. The platform uses various carescenarios including home healthcare, assisted living, nursing home ormedical facilities. It also manages various state of health or types ofdiseases. The platform is an integrated solution to provide efficient,constant connections between the patients, their caregivers and thecontinuous monitoring of the health conditions. The environmentalfactors are monitored and adjusted automatically to maintain the bestsettings favorable for the patient’s conditions. The platform advisesthe group members on the actions and choices for improving their healthstatus, e.g., based on analysis of their health conditions, with supportfrom the caregivers or other members in the group. Personalized adviceand reminders, e.g., by close family members or friends is supported onthis platform.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 shows an example of the User Interface showing the caregivingscenario between family members.

FIG. 2 shows an example of the User Interface showing nursing homecaregiving scenario.

FIG. 3 shows an example showing an elderly’s medical conditions,records, medication adherence and appointment information - managedcollaboratively by the caregivers in the family.

FIG. 4 shows a Functional Design Block Diagram - Direct access to sensordata.

FIG. 5 shows a Functional Design Block Diagram - Access to Sensor Datavia Vendor’s Cloud.

FIG. 6 shows a flow chart diagram for Automatic Environmental Controlfor COPD Patient Management.

FIG. 7 shows an example of an Alert on Unhealthy Air Quality.

FIG. 8 shows an example of Remote Adjustment of Smart Air Purifier FanSpeed and Thermostat.

FIG. 9 shows an example of an Alert Sent from the Patient’s Smartphoneto the Caregivers and/or Care Team

FIG. 10 shows a Graphical Display of the Variations in Patient’s Sp02and Activity Levels.

FIG. 11 shows an example of a Plot of the Time Variations in thePatient’s Sp02 and Activity Levels at the DashBoard App for theCareGivers and CareTeam (Remote).

FIG. 12 shows an approximate location of client (with Bluetooth Device):blue circle centred around the care home - Alerts care home staff whenthe client wanders too far.

FIG. 13 shows an activity monitoring of a patient through a webapplication.

FIG. 14 shows the detailed patient data through a web application.

FIG. 15 shows the user scenario for managing the healthy growth of ababy.

FIG. 16 shows a table for pain tracking.

FIG. 17 shows a flow chart of the work flow of collaboration betweenpatient and caregiver groups.

DETAILED DESCRIPTION

The software platform is based on a system architecture that is designedfor: “distributed, hierarchical patient monitoring”. Depending on theseverity of the patients’ conditions, some or all of the following threescenarios for care-giving may be applicable:

-   Patient self-monitoring (oneself)-   Family/ personal caregivers monitoring (M to 1)-   Doctors/ professional caregivers/ nursing homes monitoring (M to N)

A mobile health platform allows members in the group to be connected andtheir health conditions to be monitored by each other, based on thepre-configured options. The design allows immediate family members,distant relatives, neighbors, friends and/or other caregivers to beincluded in the group.

The platform supports users with a desktop PC, smart mobile device,feature phone, or plain old telephones, with features adapted to theirdevice capability.

The software platform provides an efficient tool for a patient’s healthconditions to be monitored from anywhere communication and connectivityare available. The medical history of each member, including but notlimited to: doctor’s appointments, test results, diseases history,medication and allergies, recent vital sign measurement data can bestored and updated in the personal health record, by everyone in thegroup who has been authorized by the patient. FIG. 13 and FIG. 14 showsthe detailed patient data. Besides, members in the group would be ableto communicate with each other, e.g. with updates on the patients’health conditions, and coordinate any actions that need to be takensubsequently. FIG. 17 shows a flowchart for the workflow of how patientand caregiver groups collaborate with each other. The updates can beprovided automatically, e.g. via physiological sensor or biosensor withwireless connectivity, or entered manually, based on vital signmeasurements taken manually, or patient’s self-reports.

The distributed health monitoring system would enable simpler action andearlier intervention to be taken by the caregivers, minimizing the needto seek for professional medical help unnecessarily. This would improvethe quality of life for the patients, and reduce the cost for allstakeholders. For patients who are cared by their dependable familymembers, neighbors, friends or nursing home caregivers, they wouldreceive a faster response and attention from their personal, dedicatedcaregivers who would be the “first responders” using this solution.

The escalation of alerts to the professional care team involving theprovider would be triggered only when the conditions are worse thanthose for the first trigger to the caregivers, or the intervention bythe first responders are not effective in improving the patient’sconditions. There will be different thresholds and conditions forcomparison with the vital sign and sensor measurement updates todetermine the triggers at different levels.

The system and protocol architecture are chosen with considerations onthe privacy and security of the personal health and medical data, e.g.meeting HIPAA compliance, which would be stored with encryption inindividual devices that are authorized by the Master user. The Masteruser can select to have the data backed up in the personal desktopcomputer, hard disk, server or a personal cloud service. This wouldensure the users and/or patients to have full ownership and control oftheir own data that are collected by their own devices. The patient mayproxy the privacy rights to a caregiver who can also be the Master user.The personal health records can be connected to the electronic medicalrecords which are the official records typically owned by the medicalservice providers and updated after patients’ visits with the medicalprofessionals. In contrast, the personal health record would keep trackof a patient’s health conditions anytime. In the US, this can be donethrough the Fast Healthcare Interoperability Resources (FHIR) interface.Patient’s medical information, e.g. vital signs, medicationprescriptions, lab results, radiology results, procedures and other testresults, can be retrieved through the FHIR API calls. Both records canbe combined to analyze and compare the patient’s conditions for thoroughassessment.

Medical Knowledge

The solution would provide the patients and/or their family/personalcaregivers with access to pre-screened information about variousdiseases, symptoms and treatment options. The increase of medicalknowledge would empower the patients and their families to make betterdecisions on when and where to get professional help, based on theirobservations of the patient.

Use Cases

The solution supports a variety of scenarios for various types ofcaregivers and user / patient conditions. A few examples are describedin the following subsections. The first one compares the various typesof caregivers followed by the subsection which describes various users /patients with different diseases and conditions.

Support on Different Types of Caregivers Family

Members in a family are connected through the mHealth software system,such that they can access and exchange information, such as the medicalconditions and health records via the platform as described in thisdocument. FIG. 1 shows an example of the User Interface showing thecaregiving scenario between family members. In such a “care” group,members are connected virtually. Members of a family can monitor theconditions of a sick family member remotely. Regardless of thecommunication device technology that is available to the patient, e.g.someone with only basic phones, their health information, includinghealth records, doctor’s appointments, medication can be managed bytheir family member’s smart devices, with alerts configuredperiodically, or triggered by certain events happening to the patient.

Nursing Home

In the scenario of an elderly patient living in a nursing home, thenurses or staff there may use a desktop computer, laptop, tablet orsmartphone to monitor multiple elderly residents simultaneously. FIG. 2shows an example of the User Interface showing nursing home caregivingscenario. The nursing home staff should be able to check the elderlypatient directly within a few minutes. The software provides anintegrated solution so that new vital sign measurement data can be addedto the patient’s medical record on the mobile devices running the App.

The app would allow connections to the family members of the clients atthe nursing home / care center facility, such that they can have accessto the record of that particular client from their family. The casemanagers, e.g. from the regional center, are also connected to themanager of the care center facility, with access to their own clients’records, but not the others, as shown in FIG. 1 and FIG. 2 below.Besides the interface with electronic medical records, the app wouldalso provide an interface to various official documents, e.g. power ofattorney, advanced directives, treatment agreements that are accessibleto both the elderly clients, their pre-authorized family/friends and theprofessional care team.

Professional Medical Care Team - Providers, Doctors and Nurses

Similar to the scenario of the nursing home, the professional care teamcan use the software system to monitor and manage the disease conditionsof multiple patients simultaneously. When a patient’s conditions haveworsened sufficiently to trigger the second level of alert to the careteam at the provider’s side, the recent vital sign measurements andother conditions of the patient will be sent to the team together withthe alert. The system provides the care team with the interface tocontact the patient and/or caregivers via voice call or text messages.In addition, the system allows the care team to access the recentmedical data collected for that patient remotely, and to modify orsuggest the threshold configurations for alert triggering.

User Types

Various users as shown connected in FIG. 2 can be categorized intodifferent groups based on the privilege levels and client devicetechnology capability:

Privilege Levels

1) Administrator - The most privileged user category would have theright to add or remove users to the group. Users in this category canalso determine the privilege level of each user in the group, e.g.access to certain document and information of any other individual userin the group.

2) Client / Family members of the Client - Default privilege onlylimited to the access of the client’s own document, records and otherinformation; Additional privilege to access additional information to bedetermined by the administrator, e.g. access to a client’s info by othercaregivers

3) Super Client - Higher privilege than normal clients who are residentsat the care facility and their families; For example, this can the casemanager of a regional center who has assigned one or more of theirclients to this care facility; Can access all the records of their ownclients.

Client device technology capability:

-   1) No mobile devices - their medical/health records maintained by    the other authorized users in the group, manually;-   2) With mobile devices, no sensors - their medical/health records    can be maintained by themselves and/or other authorized users in the    group, manually;-   3) With mobile devices, with sensors - their medical/health records    can be maintained by themselves and/or other authorized users in the    group, manually; some measurements and status updated automatically    via the sensors;-   4) With wearable sensors, no mobile devices (e.g. cell phones) - A    hub / gateway at the facility communicates with the wearable sensors    of these clients, updating their records with the measurement data    directly;-   5) Hub / Gateway - Connected to the group as one of the client    nodes, with the difference that it can connect to the wearable    sensor devices on those clients who do not have their own mobile    devices to collect their own measurement data. For example, this can    be a tablet computer running the mHealth app and/or maybe others    that can communicate with the wearable devices on the clients

User Scenarios for Various Disease Conditions

The mobile application is used for monitoring and management of users orpatients with various health status or disease conditions. It provides aplatform with which the medical histories, the recent conditions andreal-time measurement data for the patient can be organized and sharedamong various people who are involved in the caring of the patient. Inaddition to data sharing in a secured, private networking environment,the platform integrates the essential functions for people in thevarious caregivers’ groups to communicate with each other in real-timeso as to collaborate on the caring of the patient.

Wheelchair Users

The health status of the wheelchair users varies widely. The needs ofthose wheelchair users who are also patients with various diseaseconditions are described in the sub-sections below. A common need of thewheelchair users in the above categories would be the ability to gethelp from others when they are limited by the mobility, for example,when they need to evacuate from a dangerous situation, e.g. a fire,storm, tornado. The emergency alert system should be connected to theircaregivers who are nearby. Besides, the software system will relay anemergency alert text message to the caregivers group that is connectedto the wheelchair-bound user, whose location is tracked and shown to thegroup. Suggestions on escape routes can be provided by the softwaresystem, based on the location of the user and the correct information onthe hazardous locations. A caregiver who is nearby would be able to helpthe wheelchair user to evacuate from the location. If a caregiver is notnearby the user, a “Please help XX on a wheelchair at YY location”message can be broadcast to users of the similar app in the immediateneighborhood of the user.

Users with High Blood Pressure

For users with high blood pressure conditions, it would be helpful tomonitor their blood pressure regularly. The patients who are diagnosedwith such conditions would be prescribed medications to control theirblood pressure. It is necessary to ensure the medication is being takenas prescribed to avoid further deteriorating conditions from happening.

Ideally, a patient with high-blood pressure should monitor their bloodpressure variations throughout the day, such that interventions such asmedication can be taken when the blood pressure is near it highestlevel, e.g. within x=70-80% of the highest recorded blood pressurepreviously. Depending on the time required for the medication to takeeffect, and how fast the blood pressure is increasing, the percentage xcan be calculated by the software system. It would also take intoconsiderations the previous dosage and time at which the medication wastaken.

When such a condition of high blood pressure is detected, e.g. throughcontinuous or regular blood pressure measurements, the mHealth mobileApplication will alert the patient and the caregivers in the group aboutthe need for medication. The alert will stay until the patient has takenthe medication and responded accordingly to clear the alert. The bloodpressure measurements would be recorded at shorter intervals to detectthe changes in the blood pressure levels. The data would be used toestimate the response time to the medication, i.e. duration from thetime the medication is taken to the observation of a significant drop inblood pressure, and the rate at which it decreases etc.

The monitoring and measurement of blood pressure levels can be obtainedby sensors or measurement systems attached to the patient. Themeasurement data should be recorded on the mHealth App at regularintervals, manually or automatically, depending on the type of systemavailable to the user.

The recorded blood pressure measurement data throughout the day, beforeand after medication, are stored on the mobile device or backup in thedesktop computer, storage device or a private, secured network storagelocation. They can be pre-configured for access or shared with theprovider’s, i.e. the nurses and doctors in the care team, before thefollow-up appointment, or immediately, in case of an emergencysituation.

Cardiovascular Disease

Using the mHealth platform, family members may help the elderly parentsor relatives to monitor their heart disease conditions. FIG. 3 shows anexample showing an elderly’s medical conditions, records, medicationadherence and appointment information - managed collaboratively by thecaregivers in the family. For example, medication adherence can betracked using the mHealth platform, together with the record of heartrate, blood pressure and/or ECG measurements. Follow-up appointmentsscheduling will be part of the records for the elderly patient, withreminders sent to members of the family, for their coordination ofcare-giving responsibilities.

The measurements of heart rate, blood pressure, temperature and/or ECGetc. can be collected either manually or automatically through the useof mobile medical devices like physiological sensors. Depending on theaccessibility and accuracy of the wearable sensors, additional vitalsigns may be collected by the mHealth platform directly.

The mHealth platform will include a way for an alert to be sent to thefamily, e.g. based on the early detection of an emergency. This can bedone by analyzing the most recent measurement data samples to determineif there is any abnormal change in the “trend” of the changes in vitalsigns, as compared to the normal conditions of the patient, to determineif an alert will need to be generated.

Users with GI Issues

A user with GI diseases may share the symptoms and discomfort statususing the mobile device platform. The caregivers or family members whoare connected in the group could provide suggestions on what the patientcould do to try to relieve the symptoms. In case the symptoms persist,the patient would need to consult with a medical profession, e.g.through a Telemedicine application or visit a clinic.

The most basic solution would be based on self-reporting of symptoms,e.g. stomach ache, acid reflux, or diarrhea recording the time when theyhappened, noting the time and types of food and drinks taken prior tothe onset of symptoms, e.g. by scanning the food packaging or taking apicture of the food. Over the counter medication such as Prilosec may beused with the time recorded, noting if the symptoms were fading away.Based on the type of medication, the App can alert the patient at thetime when the medication can be taken again, e.g. at intervals of fouror more hours. The patient may enter their state of the symptoms, e.g.improvements by “N” levels, for N=1-10, where N=10 means that thesymptoms have disappeared, and whether the medication is taken at thattime. The tracking can be recorded using a similar format as shown forthe pain management in FIG. 16 .

A few different types of sensors for detecting GI issues have beendeveloped. The classic approach is to measure the PH level inside the GItract, e.g. stomach. Another non-invasive approach has been developedusing external sensors that detect the movements in the GI tract, basedon the application of signal processing techniques to the measurementdata collected by the sensor array. When those sensor technologies areapproved by the regulatory bodies and become available commercially, theGI issues may be predicted with warning provided in advance throughearly detection. The effectiveness of the medication may be determinedthrough the changes in the measurement data collected by the sensors,before and after medication is taken.

Another way that this App can help users with GI issues is to send themregular alerts at the time for medication, and regular meals or snacks,with suggestions on the type of food to eat or avoid, based on the GIhistory. The alerts at time interval between meals and diet can beconfigured and adjusted during the doctor’s appointment, remotely by thedoctor, nurse, dietitian or by the caregivers per doctor’s instructions.For example, when the patient has a stomach ache, the medication has tobe taken as soon as possible, followed by a light meal with easilydigestible food that can help to balance the PH level inside thestomach. As the patient’s conditions improve, the variety of food can beincreased slowly without overloading the stomach.

The alerts can be a simple pop-up on the user’s device with a reminderfor meals, or it can display photos and links to nearby restaurants,cafes or grocery stores which have menu items suitable for the user’sdiet. To reduce interruptions to the users, the alerts for meals can becombined with those for the other events on the user’s calendar, withina similar time frame, e.g. 15 minutes.

Using this App, the diet requirements for the patient are shared amongthe other members in the group, e.g. the cook for the family would beaware of the diet requirements when the meal is prepared.

Patients With Respiratory Problems, E.g. Asthma, COPD or Lung CancerPatients

For patients with respiratory diseases, their blood oxygen concentrationlevel would be lower than normal people, while the carbon dioxide levelis usually higher than normal. A patient with such diseases should havetheir blood oxygen concentration level or carbon dioxide level measuredand monitored continuously. The measured data by the sensor can betransmitted wirelessly to the patient’s mobile device, an access point(hub) and/or a computer. Besides, other vital signs, e.g. the heart rateand temperature of the patient would also be measured and monitored bythe same or a separate sensor that will also transmit the measurementdata to a mobile device, an access point and/or a computer.

The mobile device or computer would process the measurement datareceived from the sensors, e.g. by filtering the noise using a movingaverage filter, over a configurable duration, e.g. per second/minuteetc., depending on the resolution required and the patients’ conditions.The filtered measurement data are then compared with a configurablethreshold to determine if the patient’s condition has worsened.

If the filtered measurement data, e.g. blood oxygen concentration level,heart rate, falls below the first threshold, a level-1 alert will begenerated to inform the caregivers who are the closest to the patient.In case of heart rate, carbon dioxide level, an adverse condition wouldbe triggered when the measurements are above their respectivethresholds.

As an alternative configuration, the measurement data need not befiltered at the mobile device or computer. They may be transmitted bythe sensors at the desirable, configurable intervals, e.g. per second /minute etc. In some configurations, the sensor modules would haveincluded some filtering and signal conditioning functions.

The App will also collect environmental sensor measurement data, e.g.temperature, humidity and air quality etc., besides the vital sign. Theenvironmental information can be collected from a smart thermostat orsmart air purifier/air quality sensor which can send the measurementdata via wireless connection to the mobile devices. The patient orcaregivers would be alerted when the environmental conditions may causea flare-up of the patient’s condition.

A closed-loop control mechanism can be used to adjust the fan speed /air flow at the air purifier or the temperature setting at thethermostat, when the environmental conditions may have caused worseningof the patients’ vital signs. It may also be used to adjust the oxygenflow rate at the oxygen tank or concentrator, through commands sent viathe wireless link connecting a mobile device to the instrument.

Diabetes

For Diabetics patients, the blood glucose level would need to bemonitored regularly. Traditionally, this is done by punching the fingertip of the patient to get a drop of blood onto a test stripe which isthen inserted into a meter to determine the blood glucose level. Usingthis app, the measured blood glucose level can be entered into therecord sheet in the mobile device. This helps the patients and theircaregivers to keep track of the changes in blood glucose levels, atdifferent times of the day when the test of taken. The app willautomatically associate the recorded level with the time and date atwhich the data was entered. Alternatively, the measurement data can beentered into the patient’s record automatically through a connectioninterface between the device that reads the blood glucose levels and themobile device.

Moreover, continuous monitoring of glucose level would be morebeneficial for the patients. This could be done by analysis of thepatient’s blood, tears, saliva or sweat using appropriate sensors. Withbluetooth or other wireless modem integrated into the sensor modules,the real-time measurement data can be transmitted to a mobile devicewhich is running the app, such that the patient’s record would beautomatically updated with the latest measurement data.

An insulin pump that has a wireless interface can enable the remoteadjustment of the amount of insulin in accordance with the blood glucoselevel. The flow of insulin at the pump can be adjusted through aclosed-loop control system, based on the measured blood glucose level,such that a desirable level can be maintained.

The mobile platform can be used to adjust the flow control of theinsulin pump wirelessly. The app would calculate and adjust the dosageof insulin necessary to maintain the desirable blood glucose level,through continuous monitoring of the blood glucose level, taking intoaccount the response time required for each insulin injection. Theresponse time can be estimated based on historical data, e.g. throughthe monitoring of blood glucose level changes, at shorter timeintervals, starting at the time a certain dosage of insulin is injected.

The blood glucose level sensor can be integrated with the needle for theinsulin pump, such that there is no need for a separate needle for bloodglucose sensing.

Pre-Diabetic Users

The pre-diabetic users are those who are likely to develop diabetes in alater stage in their lives, based on their fitness level and lifestyles, e.g. low activity levels and high sugar, high fat diets. Most ofthose with high BMI values and/or with obesity are very likely tobecomes diabetics, soon or later.

It would be worthwhile for the App to help users with these conditionsto avoid from developing diabetes. The solution supported by this Appwould provide suggestions, plans and tools for these users to improvetheir health status, e.g.: Choice of weight loss programs -Nutritionaldiet with different variations, e.g. Meals with different ratios of meatto vegetables, all of which should be less than 0.5; Exercises; providelinks to resources on training classes, coaches, MeetUps for varioussports activities.

The App provides a connection between the pre-diabetic user to thefamily or close friends. The family and friends who are connected viathe App can remind and encourage the pre-diabetic user, e.g. whenexercise would be needed, and/or when meals are prepared for thepre-diabetics.

The motion sensors carried by the pre-diabetic user, e.g. in the cellphone, smart watch or wearable devices, would provide information on theamount of activity on the App that is shared by users connected in thegroup. The selected diet plan can be read by those in the user’s groupwho would then help the user on the weight loss program, by providingreminders and suggestions for dinners etc.

Patients With Emotional Issues, Eg Depression, PTSD Etc

The platform can help these patients through their “always-on”connections to their family, friends, such that any changes to theiractivities and responses can be used for symptom detection, i.e. at theonset of depressive mood. For example, there can be a message pop-upasking if they are happy at a certain time. If the answer is: “No”, orno response, an intervention can be triggered automatically or throughtheir connection in the App, as they can see the response immediately.

The supportive connection can then provide some ways of alleviation,e.g. phone call to chat, or sharing of music to help with relieving thesymptoms.

Parkinson Disease Patients

Through the detection of shaking, instabilities, jittering, it may bepossible to avoid the patient from falling, e.g. through the use of afall-prediction algorithm. Thus, before the predicted time of a fall,the caregivers nearby can be ready to support the patient from falling.With the constant connection with caregivers, e.g. family members orneighbors would be alerted of a fall or the prediction, so that they canrespond promptly to help the patient.

Alzheimer Disease / Dementia Patients

The location of the user, which is available in all mobile phones viaGPS, or a combination of GPS, wireless and/or cellular network userpositioning mechanisms, or a special GPS location tag that is carried bythe user, e.g. an Alzheimer patient, can be shown to the connected groupmembers to locate the patient who may have lost his / her way. FIG. 12shows an approximate location of client (with Bluetooth Device): bluecircle centred around the care home - Alerts care home staff when theclient wanders too far.

As an alternative to a device with GPS receiver and cellularcommunications capabilities, the distance of a simpler wearable devicefrom a host device can be used to detect the distance of the user fromthe host device, via the wireless connections. For example, as thewireless signal strength is a function of the distance between thetransmitter and receiver, it can be used as an estimate of the distance,with some calibrations.

In one scenario, the dementia patient may have a tag with Bluetoothconnectivity, which connects it to a hub / gateway located inside thenursing home where the patient resides. A tablet computer can be used asthe hub / gateway in which one or more Apps are running. If the patientwanders outside the house, e.g. for a distance more than X meters fromthe hub, then an alert would be generated by the App. There will benotifications sent to the other caregivers / mobile users who areconnected to the App. The value of X can be determined depending on thedistance of the hub from the exits of the house, such that the alertscan be triggered as soon as the patient stepped out of the door.

The tag to be carried by the patient can be in various form factor, e.g.necklace, bracelet, ring, hairpin, earrings, attached to the clothing orshoes. It can be a commercial product, or a custom-made device withBluetooth or other wireless connectivity. The App running at the hubwill estimate the distance of the tag based on the strength of thereceived wireless signal that was transmitted from the tag. In case thatinformation may not be accessible in a commercial off-the-shelf tag,then the App would need to make API calls to retrieve the distance infoof the tag and the patient.

In the case of a custom made device, it would consist of a wirelessmodem, e.g. Bluetooth transceiver, an antenna, a power supply or as analternative: a solar cell, pressure sensor, piezo-electric device orother energy harvesting circuits, in its simplest form, to transmit andreceive signals from the hub.

Infants and Children

The app can be used to start organizing and storing an infant’s growthand medical record, e.g. Regular temperature measurements; Regularheight, weight measurements; Immunization record; Diet: meal - type,amount etc.; Days of special events: first tooth, first time to standand/or walk, first word spoken; Pointers to the events would beavailable to help the users to retrieve the photo or video. FIG. 15shows the user scenario for managing the healthy growth of a baby. Thiswould document the infant’s personal health record, from the verybeginning. Location of children who do not yet carry a cell phone can bedetermined by other ways, e.g. using wearable devices with locationtracking capabilities, RFID tags etc., similar to that used by adementia patient as described above.

Healthy Users

As it has been recommended by the World Health Organization, the USSurgeon General and the American Heart Association, an adult shouldperform a minimum of 150 minutes of moderate exercise per week, toprevent against various chronic diseases. Healthy eating habits havebeen recommended for chronic disease prevention, e.g. through myPlate orthe Harvard food plate. Besides, adequate sleep time with good qualityis also important to one’s health.

Thus the App would provide information to help the healthy users tomaintain their healthy status. Similar to the monitoring of patientswith medical issues, the App would gather information from the wearabledevices, e.g. activities level and duration, sleep duration, heart rateetc. By analyzing the data and display the results in an intuitiveapproach, the users can learn and get advice on whether they need toincrease their activity levels and improve their sleep. Below is a listof additional features to support healthy lifestyle choices and habits,for example:

Suggestions on nearby restaurants with healthy menu items, withnutritional information, including the health benefits associated withthe ingredients, e.g. broccoli, tomatoes with high anti-oxidants forcancer prevention; based on the user location as determined by themobile device; Suggestions on opportunities for exercises, e.g. walking,hiking trails, swimming pool and sports courts nearby; information canbe provided when the user searches for directions to a certain locationto remind the user to plan the exercise time as part of the trip; basedon the user location as determined by the mobile device; Ad hoc meetupsfor people who are located nearby, e.g. as posted on Meetup.com,Eventbrite or, events happening in the time frame when you travel to aneighborhood; Connections with family members, friends or neighborswould facilitate the organizing of physical activities jointly, whichwould help to motivate and sustain the habit of exercise; Activities canbe tracked automatically to estimate the level of physical activitiesaccomplished and suggest additional ones to meet the goal, e.g. joiningother friends for a walk; Reminders are provided to the mobile deviceusers to alert them the time for exercises; these can be configured astext messages, the user’s favorable music, machine voice, orpre-recorded sound, pet’s or human voice.

For example, a loved one may have pre-recorded a warm and gentlereminder, e.g. “Hey Friend, it seems that you have not done enoughexercise today, would you like to go for a walk before the sunset, whichis forecast for an hour from now? Maybe you can try to return the missedcalls as you walk.” In this example, the pre-recorded message will beplayed at about an hour before the sunset, based on the weatherforecast. Alternatively, this can be displayed as a text message at thesimilar time. The reminders for exercise can be set to a lower priority,and delayed until another higher priority event on the calendar hasended; Incentives can be provided to the user as encouragement when somesignificant improvements have been made, e.g. increase levels ofphysical activities as compared to the previous day, or the achievementof predetermined goals; Incentives can be in the form of a free musicdownload which is beneficial for emotional health, coupons for Yoga,Zumba, or Taichi classes, free passes to the gym, or health food /drinks etc.; Incentives can be sponsored by various vendors which couldmake use of this opportunity for acquiring new customers or futuresales; Weight information can be captured in a record for the users,e.g. manually or via wireless connectivity at the scale, if available.

Sleep Apnea

The App can be used to detect symptoms of sleep apnea and alert theusers and/or their family or roommates to wake them up.

The user would have to wear a pulse oximeter (Sp02) sensor when they goto sleep, ideally wearing an activity tracker at the same time. The Appwould monitor the Sp02 level and heart rate while the user is sleeping.When a drop in the Sp02 level is detected below an abnormal level, itserves an indication that there might be an obstruction in the user’sairway. An alert would then be generated to wake up the user, caregiveror roommate to make sure the user change the position of sleep to allowclearance in the airway.

Chronic Pain Management

Tracking of pain symptoms, location, activities type, duration can besupported by the App, either manually, or semi-automatically, e.g. whena smart activities tracking device is worn by the patient. Theinformation tracked would include the activity and its start and endtime, the time when the pain was felt and disappeared, as shown in theexample in FIG. 16 . Based on the information about the pain “profile”,the App can estimate the approximate duration that the patient canengage in a certain activity and alert the patient to stop that activityand take a rest, before the pain hits. The alert can be configured asthe patient’s favorable music, machine voice, or pre-recorded sound,pet’s or human voice . For example, a loved one may have recorded a warmand gentle reminder, e.g. “Hey Mom, it seems that you have been walkingfor a while now, would you like to sit down and rest a little bit, checkyour email or p lay an on line game ? You can text or ca llme to chat ifyou like.”

Features

-   1. Personal electronic health / medical record    -   a) A personal copy of health / medical record can be created by        and maintained by everyone using this platform.    -   b) Collaborative review and update of the personal health record        can be done by the caregivers and other authorized individuals.    -   c) Integration with electronic medical record-   2. Messaging - Users connected in the group can communicate with    each other using text messages, voice and/or video messages. The    voice or video messages can be configured to play back at specific    times, e.g. at the time of medication, as a reminder to the    patient. a) text; b) voice; c) Video-   3. Calls - from simple checking / interviewing of the patient to    remote consultation with an expert medical specialist in the    field: a) Audio call: 1-1; b) Audio conference calls: > 2 people on    the call; c) Video calls: 1-1 or conference call. Members in the    group may join a conference call consultation between the patient    and a provider or professional care team to discuss the health    issues and treatment plans. The personal health record with the    latest measurement data and conditions collected through the    continuous monitoring system can be shared with the provider or    professional care team during the video call consultation. This    system would improve the quality and experience of remote medical    consultation or telehealth, through the provision of patients’    recent and detail health information.-   4. Measurements and record updating- a) Manuel; b) Automatic; c)    Periodic; d) Remote trigger; e) Remote configuration changes.-   5. Alerts- Different levels of alerts can be generated based on    severity levels of the situations:    -   a) Emergencies - Call the paramedics;    -   b) Level 3 - Notify doctor or medical professional care team for        the earliest appointment or remote consultation using        telemedicine;    -   c) Level 2 - Caregiver team, e.g. family or nursing home care,        personal attention;    -   d) Level 1 - Additional measurements;    -   e) Reminders.    -   For example, if the Sp02 level has started to drop below a        certain threshold, when the activity level is unusually high,        the App will generate a Level 1 or 2 alert to advise the COPD        patient and the caregivers that the activity level should be        reduced. At the same time, the App will continue to monitor the        conditions of the patient more closely, i.e. sampling the SpO2        level, heart rate and activity levels, and check the        environmental factors, e.g. temperature, humidity and air        quality, more frequently. If the environmental factors have        improved, activity level has reduced, but the Sp02 level or        heart rate haven’t improved, and the medication has already been        taken, the next level of alert will be generated to notify the        medical professional care team, which would be provided with        access to the recent measurement data on vital signs,        environmental data, activity and medication history for the past        few hours.-   6. Medication information and tracking    -   a) Medication history - Prescribed, amount taken, effectiveness,        side-effects;    -   b) Current medication - Prescribed, amount taken, remaining        quantity, effectiveness & side-effects;    -   c) Information on medication - Expected responses (time),        side-effects-   7. Doctors′ (Dr.) information —    -   a) Upcoming Dr. appointments and past visits    -   b) Other doctors nearby: education, experience, reviews    -   c) Best doctors recommendations (ratings) References - identify        in the network, e.g. through collaboration with other websites,        or based on accumulated ratings by users of this App-   8. Medical facilities information    -   a) List of various facilities nearby, and at various distances:        specialty & ratings    -   b) Alternative medicine, e.g. Chinese medicine, Acupuncture,        other holistic care    -   c) References - identify in the network, with information        verified before sharing it with the users-   9. Provides information on emergency procedures, e.g. first aid,    choking etc.-   10. Nutrition, exercise and other advice.

System Architecture

A distributed, secured system architecture with flexibility in thenumber and configuration of end nodes can be implemented. In one option,there will be a Master user with the highest level of privileges toconfigure the privacy settings to allow different levels of access todifferent data files for various users connected to the group. Inanother option, each user can configure the privacy setting for sharinginformation with various users, if the user is the original owner of thedata. There can be sub-groups within the group, such that someinformation sharing can be limited to the subgroup members, to ensureprivacy under different levels of sharing. The software system mayconsist of one part that would run on various mobile devices that areconnected through to the same group, and another part that would run ona remote server. It would be possible for the devices running thesoftware to connect and communicate with each other, even withoutconnection to the server or Internet. When Internet is available, andthat it is desirable to connect to the server, the user can configurethe devices to have the data backed up to the server, and/or performcertain computational operations. For example, the data backed up can beconfigured to perform during charging and/or under WiFi connection. Thiswould imply that part of the database to be available on the users’devices locally, e.g. with the most recent and important informationabout the users.

Remote Patient Monitoring - COPD

The system design as described in the following sections is used formonitoring patients’ conditions continuously, and to respond withvarious actions to improve the patient’s condition, depending on theconditions and effectiveness of other actions, either manually,semi-automatically or automatically. Different components of the systemare connected wirelessly in the patient’s vicinity and remotely to thepatient’s care team, to allow remote monitoring and intervention, ifnecessary. A patient is equipped with various sensors which can be oneor more integrated modules with wireless connectivity, e.g. to measureand track the patient’s vital signs and activities continuously.Similarly, there may be other sensors in the patients’ environment thatcan provide information on the environmental factors, e.g. temperature,humidity and air quality etc., through a wireless connection. Inaddition, there could be equipment and appliances that can be connectedto the host device which may then control the settings andconfigurations of the former to improve the patient’s conditions. Thehost device can be configured to alert the patients’ caregivers and/orcare team when certain conditions are detected which are not improvablethrough adjustments of the environmental conditions and equipmentsettings.

In general, some basic processing of the sensor data samples areperformed by the microprocessor (MCU/CPU) at the sensor module beforetransmitting to the host devices. Some sensor modules may allow thesoftware on the host devices to access the received sensor data, e.g. bydecoding the data received via the wireless link with the sensor module.Other sensor modules may require a host device to transport the receiveddata to a remote server without allowing the decoding of the sensor dataat the host device. In the latter, the host device could issue an APIcall to the server to retrieve the sensor data after transporting themto the server.

Operation Scenarios Indoor Scenario

When the patient is located indoors, the system can connect varioustypes of sensors to a smart watch, smartphone, tablet and/or othercomputing devices, e.g.: Physiological sensors and/or Biosensors, e.g.,sensors for heart rate, respiratory rate, blood oxygen concentration,blood glucose levels, temperature and activity level; Environmentsensors on the home appliances, e.g., thermostat, air quality sensor atthe air purifier, (de-)humidifier etc. Other sensors on the mobiledevice or other wearables that the patient is carrying, e.g., motionsensor, accelerometer, gyroscope etc. sensors on medical equipment,e.g., oxygen concentrator, or oxygen tank, or insulin pump.

On a regular basis, the physiological sensor data is received by thepatient’s App, which can be run on a smart watch, smartphone, tabletand/or other computing devices. The sensor data is processed, e.g.,filtered, de-noised, averaged, and compared with some thresholds todetermine the patient’s condition and respond in correspondence, asshown in the block diagrams FIG. 4 and FIG. 5 . In the manual mode, thepatient is alerted of “Unhealthy Air Quality”, e.g. per the air qualityindicator as received from the smart air purifier, with an userinterface that allows the change (increase in the case of unhealthy airquality) of fan speed at the smart air purifier, and adjustment of thethermostat, as shown in FIG. 7 and FIG. 8 . When the patient’s conditionis worsened, an alert can be sent from the smart device to thecaregivers and/or the medical care team, including all the sensor data,as shown in FIG. 9 . Besides the manual mode, an automatic mode is alsosupported using close-loop control mechanism, as shown in the exampleflow chart in FIG. 6 . Although not depicted in FIG. 6 explicitly, it ismeant that mobile application will alert the patient, caregivers, doctorand care team about the adverse conditions, if the patient’s conditionshad not improved after attempting to automatically improve theenvironmental factors and/or oxygen supplies, e.g. at the maximumsetting of the oxygen supply. The sensor data as collected and processedby the patient’s computing device can be displayed to the usernumerically and/or graphically (FIG. 10 ), and sent to the server cloudwhere they can be shown to the caregivers, doctors and care teams viatheir dashboard applications or other types of user interface, remotely.An example of the dashboard application is shown in FIG. 10 . Otherformats for the data plot can also be supported by the dashboard toallow more detail analysis by the care team, e.g. scattered or lineplots. In FIG. 10 and FIG. 11 , the plots show time variations (x-axis)of the patient’s Sp02 measurements (y-axis) and the correspondingactivity level, as averaged over each minute. The size of each bubble isproportional to the estimated activity level during the measurementinterval. Other variations on the plot style could also be supported,e.g. with size of bubble proportional to the Sp02 levels. Similar plotsare used to show the variations in other vital signs, e.g., heart rate.

Outdoor Scenario

When the patient is planning to venture outdoors, mobile applicationwill allow the user to check the air quality of the destination and/oron the route, as appropriate, and advise the patient on the risk levelof the planned trip. If the patient has decided to go outdoor, thesystem will continue to monitor and update the air quality of thepatient’s current location, e.g., by sending periodic inquiries to theair quality web server, based on the current GPS location:http://www.airnow.gov/index.cfm. Similarly, other environmental factorssuch as temperature and humidity will also be monitored and updated forthe patient, e.g., by inquiring the web server:https://weather.comweather/today/ /weatherht://weather.com/weather/today/

It would be possible to have mobile / wearable environmental sensors tomeasure and monitor the environmental factors, e.g. air quality,temperature and humidity, in the patient’s vicinity.

Data Aggregation

The design as described here aggregates various types of data, includingbut not limited to the list as follows:

Real-time patients vital design data from wearable physiological sensorsor bioSensors, e.g., Sp02, heart rate / variability, skin temperature,respiratory rate etc.

Location and motion data from patient’s Smartphone, e.g., location,speed of movement, altitude, number of steps & stairs, etc.

Environmental sensor data when available:

-   Indoor: Air Quality index (Smart Air Purifier), Thermostat with    wireless connectivity (Temperature, humidity);-   Outdoor: Web sites with temperature, humidity, pollen/pollution/air    quality index data for the queried location;-   Server data for retrieval, e.g., patients’ historical data etc.,    reference vital sign data for comparison with patient’s current    measurements;-   Data for storage at server, e.g., new vital signs and sensor    measurement data (1-3) after filtering & other processing;

Features

The major features that are supported by the health monitoring systemcan be summarized as follows: Based on the weather (Temperature &humidity) conditions, air quality, and flu infection rate, the healthmonitoring system can warn the user with respect to the risk level of acertain location, e.g., before the user goes there; obtain thermostatdata & control for the patient’s comfort indoor; It can monitor theblood oxygen level regularly, alert the user and/or care-taker when itfalls below a Threshold, e.g., T1, and increase the oxygen supply level;If the level does not increase after a certain time duration, mobileapplication alerts the user, care-taker and/or doctor; or If the bloodoxygen level continues to drop and becomes lower than another Threshold,e.g., T2, then the health monitoring app would alert the user,care-taker and paramedics; It monitors the blood oxygen level as theuser moves, e.g. record the location and speed of the user through thepatient’s smart watch, smartphone, and/or other wearable devices; itsaves the data for analysis and use to predict when the user mightexperience a problem, based on their location and activity in thefuture; it warns the user against the location and activity when aproblem is predicted; compares the New data with the earlier data tocheck if there is any deterioration of the patient’s condition; If thecondition has worsen, it alerts the patient and/or care-taker toschedule an appointment with the doctor; The data as related to locationmay be further processed and analyzed for use as an indicator of thepollution level at that location, and use to warn other users who aretraveling to that area; it alerts patient / caregiver when the Oxygentank needs a re-fill; provides voice alerts / advice to patient. It canalert patient to take medication and keeping track of the medicationrecord.

Sensor Data Processing Optimizing for Power Consumption

An optimized system would allow the minimal power consumption at thesensor modules by adapting and sharing the sensor processing andcomputational load with a host device, e.g., a smartphone, tablet orother devices with processing power. For example, if the powerconsumption for processing a set of samples X over a certain measurementinterval T is Px,c, and for transmitting the samples is Px,t:

-   (i) Px,t < Px,c => Transmit the samples to the host device-   (ii) Px,t > Px,c => Process the samples on the sensor modules

In Case (ii), the results of the processed sensor samples are sent tothe host device at an interval greater than T, with a smaller amount ofdata as compared to (i).

Signal Conditioning

The sensor measurement data would need to be de-noised, e.g. throughfiltering and/or thresholding. After the measurement sample isde-noised, it is then compared with the nominal or expected value whichcan be specific to the patient’s medical condition. If the new sample isworse than the expected value, then an alert can be generated to informthe caregivers who are connected to the patient, e.g. via a mobile appsimilar to the one shown in FIG. 11 .

Data Processing

The measurement data can be passed through a moving average filter. Theoutput of the moving average filter can be plotted and compared with thereference value, e.g. similar measurements taken at the most recentdoctor’s office, in the case of vital signs.

The length or duration of the moving average filter can be configured tooptimize between de-noising, which is more effective with longer filterlength, as a tradeoff to sensitivity of responses to changes.

Calibration

The measurement data from the sensors can be re-calibrated periodically.One way to calibrate the sensors is to compare the filtered measurementdata with the vital sign reading taken using a more stable, clinicalgrade equipment, e.g. by a caregiver or nurse.

The difference in the reading is used by an algorithm to determine ifthe current measurement would require any attention by the caregivers.

Alert Generation

Besides the comparison with the reference measurement data, the expectednormal and abnormal readings would also be taken into account by thealgorithm, when an alert is generated for attention at different levels.

An alert is generated based on multiple measurement data or metrics,e.g. if the air quality index shows good air quality, the user does nothave abnormally high activity level, and the heart rate is normal, butthe Sp02 level is x% lower than the “normal” level for this patient,then an alert would be generated with a suggestion to check the oxygensupply.

In another case, if the Sp02 level is lower than normal while heart rateis higher than normal, with an indication that the user has relativelyhigh activity level, then the alert would be generated with a suggestionfor the user to stop the activity and take a rest. After some time “T”,e.g. 5 minutes, the algorithm would check the latest conditions, e.g.Sp02 level and heart rate, to determine if a higher level of alert wouldbe necessary, or the current alert can be cleared, in case the vitalsigns are back to the user’s normal value, after the user has stoppedthe activity.

Monitoring of Other Disease Conditions

While the examples as shown in this document are described for themonitoring of a COPD patient, the monitoring of other diseases can alsobe done using similar methodologies as described in this document, withinputs from a combination of similar and different types of sensors. Forexample, monitoring of blood glucose level indicator instead of Sp02level; and the adjustment of the amount and frequency of insulininjection, instead of flow control on the 02 supply.

In another embodiment, when the sensor measurement data is updated, thecaregivers can see the updated information via the connection by amobile App. The caregivers connecting to the patient can see similarinformation about the patient.

All examples and conditional language recited herein are intended foreducational purposes to aid the reader in understanding the principlesof the invention and the concepts contributed by the inventor tofurthering the art, and are to be construed as being without limitationto such specifically recited examples and conditions. Moreover, allstatements herein reciting principles, aspects, and embodiments of theinvention, as well as specific examples thereof, are intended toencompass both structural and functional equivalents hereof.Additionally, it is intended that such equivalents include bothcurrently known equivalents as well as equivalents developed in thefuture, i.e., any elements developed that perform the same function,regardless of structure.

We claim:
 1. A mobile health management system, comprising: a mobileapplication running on a mobile device with an user interface to receivemanual data input from an user, and to display data; personal healthrecords for at least one individual stored on a mobile device runningsaid mobile application; wherein a personal copy of the health record iscreated and maintained by said user of the mobile application; whereinsaid personal health record is accessible for review and update by atleast one member of said user’s authorized caregiver group; whereinadditional personal health records are created and maintained forpatients/clients whom said user is an authorized proxy; a databasesystem on said mobile device to store personal health records; anupdating function to transmit and/or receive any updates of saidpersonal health records to said caregiver groups of saidpatients/clients; an alert function to alert said user and/or at leastone member in the caregiver groups.
 2. A mobile health management systemof claim 1, further comprising: an interface between said mobileapplication and sensors to receive sensor data; a software moduleintegration between said mobile application and sensors to receivesensor data; a data processing module to process received sensor data,to update the personal health records; and an alert function to evaluateprocessed data to determine if an alert is needed.
 3. A mobile healthmanagement system of claim 1, wherein said alert function alerts saidmembers of caregiver groups, when health conditions worsen to meetingthe criteria of alert levels, alerts a another members of caregivergroups, and when health condition deteriorates further, alerts a anothermembers of caregiver groups that may include professional care team. 4.A mobile health management system of claim 1, wherein said personalhealth records are accessible by said caregiver groups and saidcaregiver groups are in constant communication with said patient viamobile application, which provides a platform for rapid updates to thepatient’s personal health record and said platform allows members toseamlessly contact patient via phone, text and video callssimultaneously within said platform.
 5. A mobile health managementsystem of claim 1, wherein said personal health record system can beconnected to the official electronic medical records at a professionalprovider’s systems.
 6. A mobile health management system of claim 1,wherein said personal health record system has an interface to variousofficial documents and forms.
 7. A mobile health management system ofclaim 2, wherein said sensors input include vital signs sensor.
 8. Amobile health management system of claim 2, wherein said sensors inputinclude environmental sensors.
 9. A mobile health management system ofclaim 2, wherein an automated control module adjusts environmentalfactors or medical device connected to said mobile application when saidenvironmental factors exceed and/or patient’s vital signs worsen.
 10. Amobile health management system of claim 2, wherein at least one mobiledevice is configured as a hub that would interface with the wearablesensors by various people in the vicinity and collect the measurementdata for their personal health records.
 11. A mobile health managementsystem of claim 1, wherein inputs to the alert function include remoteenvironmental data.
 12. A mobile health management system of claim 1,wherein said alert function uses seamlessly integrated telephone, video,audio and text messages between patient and caregivers and provides anaudio and/or visual indicator.
 13. A method to manage health for acommunity, comprising: a mobile application running on a mobile devicewith an user interface to receive manual data input from an user, and todisplay data; personal health records for at least one individual storedon a mobile device running said mobile application; wherein a personalcopy of the health record is created and maintained by the user of themobile application; wherein said personal health record is accessiblefor review and update by at least one member of said user’s caregivergroup; wherein additional personal health records are created andmaintained for patients/clients whom said user is an authorized proxy; adatabase system on said mobile device to store personal health recordsand updates; an updating function to transmit and/or receive any updatesof said personal health records to said caregiver groups of saidpatients/clients; an alert function to alert said user and/or at leastone member in the caregiver groups.
 14. A method to manage health for acommunity of claim 13, further comprising: an interface between saidmobile application and sensors to receive sensor data; a software moduleintegration between said mobile application and sensors to receivesensor data; a data processing module to process received sensor data,to update the personal health records; and an alert function to evaluateprocessed data to determine if an alert is needed.
 15. A method tomanage health for a community of claim 13, wherein at least one mobiledevice is configured as a hub that would interface with the wearablesensors by various people in the vicinity and collect the measurementdata for their personal health records.
 16. A method to manage healthfor a community of claim 13, wherein said alert function alerts saidmembers of caregiver groups, when health conditions worsen to meetingthe criteria of pre-configured alert levels, alerts a another members ofcaregiver groups, and when health condition deteriorates further, alertsa another members of caregiver groups that may include professional careteam.
 17. A method to manage health for a community of claim 13, whereinsaid personal health records are accessible by said caregiver groups andsaid caregiver groups are in constant communication with said patientvia mobile application, which provides a platform for rapid updates tothe patient’s personal health record and said platform allows members toseamlessly contact patient via phone, text and video callssimultaneously within said platform.
 18. A method to manage health for acommunity of claim 13, wherein said personal health record system has aninterface for connection to the official electronic medical records at aprofessional provider’s systems.
 19. A method to manage health for acommunity of claim 13, in which said personal health record systemincludes various official documents and forms.
 20. A method to managehealth of a community via at least a mobile device, comprising:receiving personal health data for at least one member of the communitythrough user input and/or sensors; processing and storing personalhealth data on said mobile device; updating personal health record forsaid member of the community; displaying updated data elements,highlighting values exceeding unhealthy threshold levels; sendingupdates of personal health data to other authorized members of thecommunity; alerting at least one member of the community using differentlevels of alert generation; and advising patient and caregivers onactions so as to improve the health condition.